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9 NEWS maltatoday | SUNDAY • 6 APRIL 2025 JAMES DEBONO jdebono@mediatoday.com.mt 60% of drug users hospitalised for social reasons MORE than half of psychiatric admissions at Malta's mental health hospital were related to substance use disorder (SUD) and were primarily due to social issues, rather than medical or psychiatric deterioration, accord- ing to a recent study published in the Malta Medical Journal. The study, conducted by Emma Camilleri, Caroline Vassallo, and Kristian Sant, analysed 95 patient records over a 13-week period between October 2021 and Jan- uary 2022. It found that social factors, in- cluding financial instability, un- employment, housing issues, and lack of social support, prompted 58.8% of psychiatric admissions among substance users. In con- trast, 34.3% of patients were ad- mitted with a comorbid mental health illness, while only 6.9% were admitted for stabilisation before entering a rehabilitation programme. The authors noted that sub- stance users often forwent exist- ing community aid infrastructure and instead presented themselves to the emergency department or an emergency general practition- er. "This often-prompted hospi- talisation for social rather than acute medical or psychiatric complaints. However, acute medical facilities often could not provide immediate solutions for long-standing social issues," the study said. Despite initial referrals often citing mental health deterio- ration or suicidal ideation, the study found that social hardships were the predominant factor leading to hospitalisation. This suggested that many individuals with SUD used hospital admis- sion as a gateway to access social services, which remained difficult to navigate or were not tailored to the needs of substance users. Homelessness and psychiatric admissions A striking 17.65% of patients admitted to the hospital were homeless at the time of admis- sion, confirming a link between housing instability and psychiat- ric crises. The lack of accessible shelter and support services left many individuals with substance use disorder with no alterna- tive but to seek hospitalisation. The study suggested that with- out targeted housing solutions and community-based care, this trend would persist, placing fur- ther strain on Malta's mental health services. A Profile of Admitted Patients The study found that substance users requiring psychiatric ad- mission were predominantly male (79%) and under 50 (88%). While 31% were aged between 18 and 29, a significant propor- tion (30%) were aged between 30 and 39, while a further 27% fell within the 40-49 age group. 11% were aged between 50 and 59. The Southern Harbour region, which includes Cottonera, Val- letta, and other neighbouring towns, reported the highest con- centration of admitted patients, accounting for nearly 30% of all cases. This was followed by the larger North Harbour region (29%), which includes major ur- ban centres like Sliema, Birkir- kara, and Qormi. The findings also indicated that polysubstance use was com- mon, with 55.75% of admitted patients using multiple sub- stances. Cocaine was the most frequently used drug (67.3%), followed by opiates (34.5%), can- nabis (33.6%), and synthetic sub- stances (18.5%). Need for stronger community support The study called for better community-based services to re- duce the burden on Mount Car- mel Hospital, which it said was already overstretched. It sug- gested that timely, accessible so- cial service interventions, along with specialised addiction men- tal health services, could help mitigate the high rate of hospital admissions. Among the proposed solutions was the development of com- munity residences specifical- ly for individuals with SUD, as they were often excluded from general support facilities due to their substance use. Additional- ly, strengthening links between hospitals and rehabilitation cen- tres could shorten waiting times and facilitate smoother transi- tions for patients needing long- term care. Burden on the Health System Hospitalisation periods ranged from one to 64 days, with an average stay of 17.5 days. How- ever, many patients discharged themselves against medical advice, leading to frequent re- admissions. This cycle further strained hospital resources and highlighted these individuals' lack of viable community alter- natives. The study concluded that ur- gent reforms were needed to improve community-based care, enhance social service accessibil- ity, and provide targeted support for individuals with SUD. With- out these changes, hospitalisa- tion would continue to serve as the default option for those who fall through the cracks of Malta's social support system. Nearly one in five patients admitted to Malta's mental health hospital with substance use disorder was homeless, a new study reveals Social issues such as homelessness were the primary cause of admission to Mount Carmel Hospital for patients with substance use disorder The research findings indicated that polysubstance use was common, with 55.75% of admitted patients using multiple substances